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` <br />. . � � <br />' ' � � , DUZLDIric rrRrtz�r nrrr.icn��zor� • � . � ' <br />'�"�'� f. ,..� np�il:�can�. To Compl.rtc Tl�i.s. Form � <br />.. If moze than une bui.ldi.ng is�to T�✓c�nr`te°per.miL•Uw�ill besinsuolcf•orrcr�ch <br />applicat•ion for cacl� buildiri�. . �3�3 /��r�.;��µ9S�� <br />builcinq. . . -�,-,,,rr� �i <br />' �.�1+�iou� ..- . Duilding nddress;r�-=r=����=�" <br />� .Ovmer `�-' =-.,—._� Jiloc): <br />Ad3ress ��•'�k t'"i?� ; Lot — <br />Phone �'7fo-1Z Subdiyision (Plat) , , _. . <br />. Citi,y L�(t!wdooD -� , . . <br />Aiehiiect/Engineer — <br />Phune MeL-es & I3ounds (Un�)latLecl) . <br />City �_- S�c. Twp, 1:cI�'• '� <br />Contr��tor �F"� . <br />Adar�:: s „_--_ . . h.�� <br />Ciiy Phone _ • <br />.�tz*e Liceas� Number Z2�%[-� � � <br />, -. <br />. Er.piration Date 3- I -7�0 '--- ' . <br />• "RACT 1: � <br />Lots 1 and '2 '�nd the South 12 feet of LotlatBt-edcand�3 I <br />Carfield S�:cond Addition Lo Everett, as �Re�ords of Sno- �. <br />recordad in Voli}ashingtonPlats, Page� T, _ <br />homish County, — <br />- — � i:umber of Stories <br />��. , 'Basement = � <br />. . � . ••• .. Nec•r � Addi�ion Repai_r./P.emodel� <br />• � � . Valuation of Con�fi=L�ction $ ' <br />• . . �J8 2�7a /� <br />- . . Signed Dy ���� iil�l�>T�-.t� <br />: . . . . ' . For _ <br />:.. . Otaner . Phone ' <br />.� ;. ��;�.`•.,c•' ;', �: . . v <br />• ~• D� 1`ot i•7ritc IIclow This Line-For City Use Onl <br />- , ' Use Sone ' <br />_ : �Date �eceived �i'7 �P �� — <br />Firc: 2one _, <br />.' Is].an C;�ec}: Number ?�-!y `� ' ' • . . - <br />• . • . Occupar,�x-Group • <br />Valuation ____ ------ Ty�e oi Co»strucLion ,___ <br />� Pernit I'ee ' <br />. ' OccupanL' Lo�d <br />. 'S�lan Check Fee — <br />Sprinlcicrs Requirc3 _____-- <br />Total r^ee Due , • • <br />, Aatc Is�ucd � . ' : :' - <br />' , . .. ... • . .. �.i� <br />, , .'':i: �. � . � . :.,. • • � � � � , . • . .� , ' . • . , � ,� <br />. •, ' �� : • ..� . � �• . . , .. , . . . . . . . . . <br />� <br />. <br />.. . e � � , � _ � . <br />� .• �� . . • � . <br />, ,•; , <br />.� . . <br />. . . , � . . � � . <br />